Exam 3: HIV

Question 1

Stage 1: Acute infection

Answer 1

CD4: 500+

Manifestations: Flu like symptoms, chills, rash, anorexia, nausea, weight loss, weakness, fatigue, headache, sore throat, night sweats

1-4 weeks

Question 2

Stage 2: Clinical latency

Answer 2

Prolonged and asymptomatic

Anti-HIV antibodies produced

CD4: 200-499

Question 3

Stage 3: AIDS

Answer 3

Defining opportunistic conditions

CD4: less than 200

Expected findings: Chills, fever, sweats, swollen lymph glands, weakness, fatigue, weight loss

Question 4

AIDS defining opportunistic conditions

Answer 4

Kaposis Sarcoma
Pneymocystic jirovecii pneumonia
Microbacterium TB
Wasting syndrome
Candidiasis

Question 5

HIV transmission

Answer 5

Bodily fluids containing HIV or infected CD4 lymphocytes

Blood, seminal fluid, vaginal secretions, amniotic fluid, human milk

Most prenatal infections occur during delivery

Casual contact does not cause transmission

Question 6

Laboratory test

Answer 6

CD4 T-Lymphocyte count: Serves as the major laboratory indicator of immune function and prophylaxis for opportunistic infections, strongest predictor of subsequent disease progression and survival

Stage 1: 500
Stage 2: 200-499
Stage 3: Below 200

HIV Viral Load: determines viral load before beginning treatment, can be repeated to monitor disease progression, identify compliance with treatment, and determine HIV medication resistance

HIV drug resistance testing: Guides changes in medication therapy when resistance occurs, useful with CD4 counts fall despite therapy

Question 7

Goal of ART

Answer 7

Suppress HIV replication to a level below which drug-resistant mutations do not occur

Reduce HIV-associated morbidity and prolong the duration and quality of survival

Restore and preserve immunologic function

Maximally and durably suppress plasma HIV viral load

Prevent HIV transmission

Question 8

Adverse effects of ART

Answer 8

Hepatotoxicity
Nephrotoxicity
Osteopenia
Increased risk of CV disease and MI
Lipodystrophy (fat redistribution syndrome)
Metabolic alterations

Question 9

PrEP

Answer 9

One pill containing two HIV medications taken daily to reduce risk of sexual HIV acquisition in adults and adolescents age 12 and older

HIV status should be checked every 3 months

Goal: Reduce acquisition of HIV infection with its resulting morbidity, mortality, and cost to individuals and society